Board papers for Hammersmith and Fulham CCG, where patients who sign up with the controversial digital first provider are registered, show officials have been asked to 'agree the recommendation of the Babylon GP at Hand clinical and contractual assurance group to remove the list size cap of 2,600 patients registered in Birmingham'.
Babylon said it welcomed the news that 'Hammersmith and Fulham have agreed to remove the list size cap'. In June, the digital-first service was given permission to register patients in the Birmingham and Solihull area, but was restricted to 2,600 patients for the first three months.
Lifting the cap could trigger further rapid expansion of the service - which had already registered 71,764 patients as of 1 December. Hammersmith and Fulham CCG is also considering a bid from the provider to expand again to Manchester from February 2020.
The CCG has yet to agree the Manchester expansion but board papers show it could do so next month if patient safety concerns can be addressed to ensure patients can 'access all local care pathways'.
BMA leaders have repeatedly voiced concerns over the rapid expansion of GP at Hand and the primarily young, fit patient population it has attracted.
Of its 71,764 patients, 61,363 are aged between 20 and 39 years old, analysis by GPonline reveals. More than half of its registered patients are aged between 20 and 29 - and around one in 200 of all patients aged 20-29 registered with a GP practice in England are now registered with GP at Hand.
BMA GP committee chair Dr Richard Vautrey said earlier this year that 'continuing with the out-of-area registration arrangements that allow a practice to cherry-pick healthier and wealthier patients'.
He called for NHS England to commit to, fund and deliver the necessary IT equipment and infrastructure so that every practice is able to provide new ways to access services'.
A Babylon spokesperson said: 'We welcome the news that Hammersmith and Fulham have agreed to remove the list size cap on 2,600 Babylon GP at Hand patients in Birmingham. We were assured that there would not be a long delay and are glad to see that was the case. This means anyone in Birmingham who wants to join our popular NHS service is free to do so.
'We are also working with Manchester CCG and our local commissioners in Hammersmith and Fulham to roll-out services in Manchester. The plans are on schedule with commissioners having shared their assurance framework with us last week.
'As expected, the commissioners are following the same format of formally objecting in order to maintain control of the process while working closely with us, as they did in the run up to us opening our services in Birmingham. We expect to see Babylon GP at Hand offer in-person appointments and 24 hour a day digital appointments in Manchester in early 2020, in keeping with national policy that people have the right to choose their NHS practice.'
GP at Hand now has the third largest registered patient list in England after increasing it 15-fold over the past two years.
However, under digital first plans set out by NHS England earlier this year, the service could see its list broken up into more than a dozen separate contracts.
A spokesperson for Hammersmith and Fulham CCG confirmed the cap had been lifted subject to several conditions. Babylon GP at Hand has been asked to confirm points about recalls for diabetic eye screening patients, appointments for patients recalled for cervical screening and links with local breast screening services.